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Role of Radiation Therapy in the Management of Renal Cell Cancer
Department of Radiation Oncology, The Methodist Hospital, The Methodist Hospital Research Institute, Houston, TX 77030, USA
Department of Radiation Oncology, The Methodist Hospital, Houston TX 77030, USA
Division of Oncology, University of Texas Health Science Center at Houston, Memorial Hermann Cancer Center, Houston, TX 77030, USA
* Author to whom correspondence should be addressed.
Received: 8 August 2011; in revised form: 11 October 2011 / Accepted: 19 October 2011 / Published: 26 October 2011
Abstract: Renal cell carcinoma (RCC) is traditionally considered to be radioresistant; therefore, conventional radiotherapy (RT) fraction sizes of 1.8 to 2 Gy are thought to have little role in the management of primary RCC, especially for curative disease. In the setting of metastatic RCC, conventionally fractionated RT has been an effective palliative treatment in 50% of patients. Recent technological advances in radiation oncology have led to the clinical implementation of image-guided radiotherapy, allowing biologically potent doses to the tumors intra- and extra-cranially. As predicted by radiobiologic modeling, favorable outcomes have been observed with highly hypofractionated schemes modeled after the experience with intracranial stereotactic radiosurgery (SRS) for RCC brain metastases with reported local control rates averaging 85%. At present, both primary and metastatic RCC tumors may be successfully treated using stereotactic approaches, which utilize steep dose gradients to maximally preserve function and avoid toxicity of adjacent organs including liver, uninvolved kidney, bowel, and spinal cord regions. Future endeavors will combine stereotactic body radiation therapy (SBRT) with novel targeted therapies, such as tyrosine kinase inhibitors and targeted rapamycin (mTOR) inhibitors, to maximize both local and systemic control.
Keywords: radiation therapy; stereotactic radiosurgery; renal cell carcinoma
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MDPI and ACS Style
Blanco, A.I.; Teh, B.S.; Amato, R.J. Role of Radiation Therapy in the Management of Renal Cell Cancer. Cancers 2011, 3, 4010-4023.
Blanco AI, Teh BS, Amato RJ. Role of Radiation Therapy in the Management of Renal Cell Cancer. Cancers. 2011; 3(4):4010-4023.
Blanco, Angel I.; Teh, Bin S.; Amato, Robert J. 2011. "Role of Radiation Therapy in the Management of Renal Cell Cancer." Cancers 3, no. 4: 4010-4023.